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Upper Extremity Evaluation > Shoulder and Arm > Flashcards

Shoulder and Arm Flashcards

0
Q

Which joint serves as the only connection of the axial skeleton to upper extremity?

A

Sternoclavicular joint

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1
Q

As you give up mobility you give up…

A

Stability

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2
Q

Name the landmarks on the humerus

A 
Head
Greater Tubercle
Lesser Tubercle
Bicipital Groove
Anatomical Neck
Surgical Neck
Diaphysis
Deltoid Tuberosity
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3
Q

Which bone is the second bone to ossify?

A

Scapula

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4
Q

True or False, there are no direct bony or ligamentous attachments to the scapula

A

True

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5
Q

How many degrees is the glenoid oriented relative to the coronal plane of the body?

A

30-45 degrees

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6
Q

What is the benefit of having the glenoid oriented at the plane of the scapula?

A

This angle places the rotator cuff muscles at optimal length-tension relationship

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7
Q

What does the scapula articulate to?

A

Clavicle and humerus

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8
Q

What are the landmarks of the body of the scapula?

A

Subscapular Fossa, medial/lateral borders, superior border, inferior angle, superior angle, lateral angle, supraspinous fossa, infraspinous fossa, subscapular facet, greater scapular notch, suprascapular notch

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9
Q

True or false: The glenoid fossa is bigger than the head of the humerus

A

False; the glenoid fossa is smaller than the head of the humerus

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10
Q

What is the glenoid labrum?

A

The labrum consists of remnants of the capsular fold and is continuous with the articular cartilage of the glenoid

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11
Q

What is the first bone to ossify?

A

Clavicle

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12
Q

What anchors the upper extremity to the axial skeleton?

A

Clavicle

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13
Q

Where is the clavicle placed?

A

Horizontally above the first rib

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14
Q

True or False: the medial 2/3 of the clavicle is more flat than the lateral 1/3 of the clavicle

A

False; the medial 2/3 of the clavicle looks more cylindrical

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15
Q

Where is a common site for fractures on the clavicle?

A

The point at which the clavicle begins to transition from a convex to a concave bend, approximately two-thirds of the way along its shaft

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16
Q

Which ribs does the manubrium articulate with?

A

Ribs 1 and 2

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17
Q

What do ribs 2-7 articulate with on the sternum?

A

The body of the sternum

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18
Q

How many degrees of freedom does the SC joint have?

A

Three degrees of freedom (elevation/depression, IR/ER, Protraction/Retraction)

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19
Q

What are the ligaments of the SC joint?

A

Anterior sternoclavicular ligament
Posterior sternoclavicular ligament
Interclavicular ligament
Costoclavicular ligament

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20
Q

How many degrees of freedom does the acromioclavicular joint have?

A

Three degrees: elevation/depression, protraction, retraction, rotational

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21
Q

What type of articular disc makes up the AC joint?

A

Incomplete fibrocartilage disc

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22
Q

What are the ligaments of the AC joint?

A

Superior acromioclavicular ligament
Inferior acromioclavicular ligament
Coracoclavicular ligament

23
Q

What are the three degrees of freedom for the GH joint?

A

Flexion/extension, ABD/ADD, IR/ER

25
Q

What does the acronym SICK stand for?

A

Scapular malposition, Inferior Medial Border Prominence, Coracoid process tenderness, dysKinesis of the scapular movement

26
Q

Which tests will rule out a SLAP lesion compared to a labral lesion?

A

Negative O’Brien’s, Negative Biceps Pull Test

27
Q

What are the ligaments of the GH joint?

A

Glenohumeral ligaments (capsular thickenings)
Coracohumeral ligament
Coracoacromial ligament
Transverse humeral ligament

28
Q

What constitutes a Grade 4 AC sprain?

A

Posterior clavicle separation, CC and AC tear

29
Q

What constitutes a Grade 5 AC sprain?

A

Superior Clavicle separation, AC and CC tear

30
Q

What constitutes a Grade 6 AC sprain

A

Clavicle is posterior to the coracobrachialis, AC and CC tear

31
Q

What is the etiology for the sternoclavicular joint?

A

FOOSH or direct trauma to the tip of shoulder

32
Q

What is the etiology of a rotator cuff pathology?

A

Impingement, bone spurs, tensile overload, traumatic tendon failure

33
Q

What are the three types of acromial architecture?

A

Type I- flat
Type II- curved
Type III- hooked

34
Q

What are the three types of acromial architecture?

A

Type I- flat
Type II- curved
Type III- hooked

35
Q

What type of acromial architecture is common in full thickness rotator cuff tears?

A

Type III hooked acromial architecture

36
Q

What faulty biomechanics lead to impingement syndrome?

A

Poor scapular biomechanics

37
Q

What is the painful arc?

A

Painful arc begins at 30 degrees of abduction and peaks at 90 degrees of abduction with internal rotation

38
Q

What is the primary impingement syndrome?

A

Compression of the rotator cuff tendons between humeral head and anterior third of acromion, AC joint, coracoid, or CA ligament
Flexion, Horizontal ADD, and Internal Rotation during acceleration and follow through of the throwing phases lead to primary impingement

39
Q

What is secondary impingement?

A

Rotator cuff or biceps tendon impingement secondary to GH instability

40
Q

What is undersurface impingement?

A

Impingement in the 90/90 position common with anterior humeral head translation

41
Q

What are the Neer’s Progressive Stages?

A

Stage I- result of supraspinatus or biceps tendon injury presenting with point tenderness

Stage II- permanent thickening and fibrosis of supraspinatus and biceps tendon

Stage III- history of shoulder problems and pain, tendon defect (3/8”) or possible muscle tear and permanent scar tissue

Stage IV- atrophy of infra and supraspinatus, paind ruing abduction, tendon defect greater than 3/8 inches, limited active and full passive ROM, weak in resistive ROM and clavicle degeneration

42
Q

What are the contributing factors to rotator cuff tendinitis and tendinosus?

A 
Muscle imbalances between IRs and ERs
Capsular laxity
Poor scapular control
Impingement syndrome
Acromion Shape
43
Q

True or false, Rotator cuff tendons have poor vascular supply?

A

True, the supraspinatus is the most vulnerable out of the four rotator cuff muscles

44
Q

Which rotator cuff muscles are usually involved in tendinitis due to eccentric load in overhead sports?

A

Teres Minor and Infraspinatus

45
Q

What can follow rotator cuff dysfunction and can be associated with repeated stretching?

A

Bicepital Tendinitis

46
Q

What is type I Scapular Dyskinesis?

A

Inferior medial scapular border prominence, tends to be associated with labral tears

47
Q

What is type II Scapular Dyskinesis?

A

Medial scapular border prominence; tends to be associated with labral tears

48
Q

What is type III Scapular Dyskinesis?

A

Superior medial scapular border prominence: impingement syndrome and rotator cuff lesions

49
Q

What are the signs and symptoms of scapular dyskinesis?

A

Affected shoulder tends to be held lower and is rolled forward

Prominent inferior scapular border due to tight pectoralis major/minor, weak serratus anterior and lower portion of trapezius

Posterior tipping may contribute to functional narrowing of subacromial space, leading to pain when shoulder is abducted and externally rotated

Winging becomes more pronounced withf atigue and may contribute to impingement and rotator cuff injury

50
Q

What are the signs and symptoms of scapular dyskinesis?

A

Affected shoulder tends to be held lower and is rolled forward

Prominent inferior scapular border due to tight pectoralis major/minor, weak serratus anterior and lower portion of trapezius

Posterior tipping may contribute to functional narrowing of subacromial space, leading to pain when shoulder is abducted and externally rotated

Winging becomes more pronounced withf atigue and may contribute to impingement and rotator cuff injury

51
Q

What is the etiology for adhesive capsulitis?

A

Contracted inelastic rotator cuff muscles that have thickened joint capsule with little synovial fluid. Generalized pain with motions resulting in resistance of movement

52
Q

Out of the types of sternoclavicular dislocation, which one is the most serious?

A

Posterior dislocation; possibly life threatening because it could compress the trachea, subclavian artery, subclavian vein, and esophagus, must require surgery

53
Q

Out of the types of sternoclavicular dislocation, which one is the most serious?

A

Posterior dislocation; possibly life threatening because it could compress the trachea, subclavian artery, subclavian vein, and esophagus, must require surgery

54
Q

What is a Hill-Sachs lesion?

A

Osteochondral fracture of the posterior humeral head; Usually occurs with anterior shoulder dislocation

55
Q

What is a Bankhart lesion?

A

Avulsion of the glenoid labrum and its attachment to the inferior glenohumeral ligament

56
Q

What are the four classifications of the SLAP tear?

A

Type I: RC degeneration and/or fraying of the LHBT

Type II: Avulsion tear associated with LHBT damage

Type III: bucket handle tear with displacement

Type IV: bucket handle tear with tearing of the LHBT

57
Q

What are the four classifications of the SLAP tear?

A

Type I: RC degeneration and/or fraying of the LHBT

Type II: Avulsion tear associated with LHBT damage

Type III: bucket handle tear with displacement

Type IV: bucket handle tear with tearing of the LHBT

Upper Extremity Evaluation (3 decks)

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